Inspection on 15/03/10 for 2 School Cottages

This is the latest available inspection report for this service, carried out on 15th March 2010.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

2 School Cottages 16/01/06

2 School Cottages 10/11/05

2 School Cottages 30/11/04

2 School Cottages 12/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: 2 School Cottages 2 School Cottages The Street Taverham Norwich Norfolk NR8 6TD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ruth Hannent     Date: 1 5 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 2 School Cottages 2 School Cottages The Street Taverham Norwich Norfolk NR8 6TD 01603262479 NOFAX# Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Lorraine Scott,Mr Michael Scott care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 2 School Cottages is situated in a residential area of Taverham, on the outskirts of Norwich. The house is the family home of the Proprietors, Mr and Mrs Scott, and their family. It provides a home for two adults with a learning disability. The Home offers separate lounge and bathroom facilities to the service users as well as single bedrooms. The current fee levels for the service are #341 to #492 a week. 2 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection report has been completed following a visit to the home that took place over a period of three and a half hours. During this time records were looked at, residents were spoken to and the Manager and her husband assisted with the questions asked. The Manager had completed fully the AQAA (Annual Quality Assurance Assessment) that gave details of the service provided and we also received comments from surveys completed by family members and professionals involved with residents who live at 2 School Cottages. There have been no notifications to cause concern about the service. Care Homes for Adults (18-65 years) Page 5 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although this home has not had any new residents for a number of years the approach and person centred care offered to date shows clearly the way the individual needs are part of an ongoing assessment process to ensure the needs can be met fully for each person. Evidence: The home is a family style environment and details of the home is available for any potential new resident. To date that has not been necessary as the two people who live here have done so for many years and have no desire to move anywhere else. The manager holds a pre populated assessment form that she will use if and when the time comes for a new person to live with her and her husband in their small home. The Manager and her husband know the residents wants and needs very well and have clear evidence to show who is involved, from professionals and family to friends and volunteers involved in the day to day care of two very vulnerable adults. For example details were seen of the the Speech and Language specialist who has had an Care Homes for Adults (18-65 years) Page 8 of 25 Evidence: input in the swallowing needs of one person. Care Homes for Adults (18-65 years) Page 9 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident has a comprehensive care plan that clearly shows how involved in the process the resident has been. The risks are assessed and action is taken to minimise that risk. Evidence: Throughout the 3 and 1/2 hours of this visit it was very evident that decisions made are very much focused on the desires of each resident. Each part of the care plan gave clear details on the support and needs of the person that was written in a way that could be understood and led by the resident themselves. Each part of the care plan was signed by the person and the Manager. Talking to one of the residents it is clear how involved in every aspect of the running of the home she is involved in, from what and where to have lunch (sometimes they just choose to go to the pub and eat) to where they will take their holidays. Each care plan event is covered by a risk assessment that is typed and clear for all to Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: read. It covers everything from risks during meal time and feeding to journeys out in the car. It tells of the procedures to carry out to minimise the risks. These are all reviewed along with the care plan details every month and signed by the Manager. One care plan was looked at in depth and which gave a clear picture that could be read by anyone who was involved in the care of this person and know exactly what was required. Care Homes for Adults (18-65 years) Page 11 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents have many and varied activities that meet their individual needs with meals chosen and trips out planned with everyone involved. Evidence: The lives of the two residents living here is filled with beneficial activities that are both necessary and fun. Not only do they take part in the day to day running of the home by helping with chores and in the kitchen but also have time to explore new activities and experiences. One person told us about her experience in the swimming pool which had not been tried since she was a child. There is also a computer used in her bedroom giving her access to the internet. We were also told of the signs and body language observed of the one resident at a recent pub lunch visit with lots of smiles and waving at people and cars. A family member has become involved in the home and takes part in holidays and social events with the home. This is very much appreciated by the resident who told us lots of enjoyable times now had with her Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: sister. Comments on surveys received state the home is wonderful and each resident is well looked after. She has all the attention and friendship she needs with plenty of trips out and entertainment. Meals are taken as and when the residents wish. If one asks to go out they plan this. At the shops food is chosen that takes a fancy for that day. One resident is proud of the fact that she has lost weight very steadily over the past 2 years which has helped her mobility and balance. All meals were noted to be fully recorded on a daily basis showing a well balanced pattern of meals throughout. The home encourages residents to be part of the local community and besides the support of the local day services who provide support 4 days per week, 2 volunteers also help out and encourage varied and enjoyed activities. One comment was, I do not want to move from here as I love it and have all I want. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home assist the residents in a professional and yet family style supportive manner with all personal and health care needs. Medication is administered by well trained and experience people whos paramount interests are for the well being of the people they care for. Evidence: Within the care plans clear records are written as to what support the residents require for their personal care needs yet still encouraging independence and self motivation. Both residents presented clean and tidy with clothes that co-ordinated and smart in appearance. The care plan also gives evidence of the support offered from the speech and language therapist to support the diet and eating patterns within the home. On the day of this visit the GP arrived after being called earlier to see one person. Details of these visits by the Doctors or Nurses are recorded clearly and action that is required clearly logged. The medication for the residents is locked in a safe in the kitchen and covered with a Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: container that helps it blend into the kitchen fixings. The administration recordings are all within the safe along with the returns log. Discussions were held with the Manager around the control drug recently prescribed for a resident. After this inspection visit information was requested from the Pharmacist Inspector who clarified that it is not a requirement for 2 trained staff to administer medication but that clear procedures and a risk assessment would show good practise. Care Homes for Adults (18-65 years) Page 15 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home would handle complaints if they had any and the owners do ensure that the residents are supported and cared for by people who are trained and experienced in understanding safeguarding. Evidence: The home has a complaints policy and although there has been the odd niggle from residents, which are ironed out, there has been no complaints. Surveys received prior to this visit have been very complimentary with comments from professionals such as,this home is brilliant and if I ever needed to find a home this would be the one I would choose. The volunteers and day centre staff that support the owners are all trained in safeguarding. It is clear with the risk assessments and regular contact by professionals that each resident is in safe hands. Care Homes for Adults (18-65 years) Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home has a comfortable, clean and well maintained environment with ample space for the 2 residents living there. Evidence: The home is very much a family style house with the two residents included in the family environment. Unfortunately due to the needs of one a bed has now been placed into the lounge but does not stop the day to day activities as there is a second smaller lounge where people can go. Everywhere is very clean and tidy with easily washable flooring and comfortable furnishings. One resident showed us her bedroom that is very personalised and has all her own belongings around her, including a CD, television and computer. The bathroom has recently been fitted with a tracking hoist due the changing needs of one resident to ensure that a regular bath can be taken. The home is very hygienically clean with fresh towels and a bacteria hand gel dispenser discretely placed by the front door. A recently completed out-building has been converted into a comfortable office Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: allowing more space within the house. There is a locked filing cabinet where all the servicing paperwork and records such as care plans are stored safely. This office is kept locked when not in use. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are no staff recruited by this home but the residents are very well cared for by the Manager and her husband, outside agencies and volunteers who are trained and offer support correctly and safely. Evidence: The home does not employ staff directly but does have the support of the local day centre who send a member of staff 4 days per week to offer one to one time with a resident. The home is also supported by two volunteers who have been assisting for many years. Files are held for the two volunteers that show an enhanced CRB for both and all training details. Besides the mandatory courses the volunteers have also had training in Safeguarding, Mental Capacity Act and Deprivation Of Liberty. The Manager told us that the training is always kept up to date as much as possible and certificates were stored in the files to show how many and how recent training courses had been attended. One concern noted was the missing references of one volunteer. The Manager was aware of this and showed us the note written to chase up these references and which should be in place on publication of this report. Supervision and appraisal forms are completed and held in the personnel folders which were seen. The main care is offered by the Manager and her husband who are qualified and trained in all aspects of care. Both are praised and recommended by professional Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: health workers who have regular contact with the home. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a very well managed home by a competent, experienced and qualified person who ensures all procedures required of a manager is carried out. Health and safety is maintained well and the quality of the service is monitored to ensure the home is suitable for the residents cared for. Evidence: The home is managed by a husband and wife team that enhance the service by excellent team work. The registered Manager holds the management qualification and her husband is qualified to NVQ 3 in care. Throughout the visit it was very evident from both comments listened to by the resident and conversations with the couple, that the home is managed competently and professionally yet still maintaining a family style run establishment. The home does listen and hold regular informal meetings with the residents to try and form an opinion on the quality of the service. They are now to ask the opinions of stakeholders/professionals who are involved in the home so a full audit of the quality Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: of the service can take place. The comments listen to and read on CQC surveys show a very successful and excellent service is maintained at this present time. Health and safety records are completed with records seen of servicing reports and equipment checks. The home has recently taken a manual hoist into the home that does require a twice yearly service to ensure the equipment is functioning correctly and safely. All other records were up to date. The last fire officers visit was in 2007 with no requirements made at the time. It was noted that a recent hospital stay was not informed to the Commission via a regulation 37 report. This was due to a misunderstanding of the regulation requirements and which is now clear to the Manager. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 33 The home needs to chase the references for the volunteer, although they are known and have been volunteering in the home for a long period of time. The home needs to ensure the hoists are serviced as recommended. The Commission needs to be notified of incidents and accidents as stated in Regulation 37 of the Care Homes Regulations. 2 3 42 42 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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